As feds ease access to prescription heroin, B.C. could see relief: doctor

A doctor working the front lines at Canada’s only clinic to offer prescription heroin says Ottawa’s recent move to make access to safe opioids easier could very-well help curb the death toll in the B.C.

Health Minister Ginette Petitpas Taylor announced Monday that legal changes will allow Canadians suffering from opioid use to have access to prescription heroin in addiction clinics, while methadone treatment will be available through health-care practitioners without any need for federal exemption.

At Crosstown Clinic in Vancouver, lead physician Scott MacDonald said about 130 patients are currently seeking injectable diacetylmorphine – the active ingredient in heroin.

“It’s a difficult treatment to take,” he said. “It’s not easy to come here three times a day, and for people to do that is a testament to their health and being well.”

The federal government has a significant role to play in removing barriers to treatment. Today, I announced that access to prescription heroin and methadone will now be simpler for those suffering from substance use disorders. pic.twitter.com/Nm37HJZsUy

Through its provincially-funded heroin maintenance program, the clinic allows people who did not see success through other forms of addiction treatments inject the medical-grade heroin as many as three times a day.

The clinic, run as a hospital by Health Canada standards, has been offering the historically controversial treatment for four years, originally mirroring evidence-based treatments implemented in Europe.

MacDonald told Black Press Media that while specific details on how the federal government plans to ease access for drug users are still in the works, access to clean and safe drug treatments like prescription heroin and suboxone could bring relief to all corners of the province.

“There certainly could be more standalone clinics like Crosstown,” he said, “but in remote areas [with fewer people] this could be incorporated into any primary community health centre and potentially even be prescribed in pharmacies.”

Since the province declared its own health emergency in 2016 – following a devastating increase in the number of overdose deaths caused by the illicit opioid fentanyl – B.C.’s top health officials have recommended prescription heroin and suboxone treatments in order to provide a spectrum of support for recovering drug users.

Health Canada estimates that 4,000 people died last year from illicit drug overdoses – more than 1,400 of those deaths occurring in B.C.

“Canadians are accepting this is a chronic relapsing illness – just like diabetes or high blood pressure – but manageable with treatment,” MacDonald said.

Currently, about three people each day die of an overdose in the province, according to the latest stats from the Coroners Service.

The patients that walk through Crosstown Clinic’s doors are “long-term drug users,” averaging about 15 years, who have been through treatment more than 10 times but haven’t seen any success.

It’s a continuum of care, like what’s currently offered at Crosstown Clinic, that’s allowed for about 20 per cent of patients to decrease from prescribed heroin to less intensive treatment options.

“Diacetylmorphine is just another opioid, it’s just another pharmaceutical like hydromorphone or morphine. Yes it needs to be kept safe and secure but it doesn’t need to be treated any different,” Macdonald said.

And while the rising death toll is one facet of the overdose crisis, MacDonald said prescribed heroin would lower the costs of treating those suffering from opioid use.

Access to the clean drugs at Crosstown costs the province roughly $25,000 per patient per year.

“There is certainly the toll of lives lost, but the cost of somebody using illicit opiods just to the criminal justice system is enormous,” MacDonald said. In a study conducted by the group behind Crosstown Clinic in 2000, it costs the criminal justice system about $48,000 per drug user each year, not including the cost of damage to property or stolen goods, he said.

“The bulk of the people that are dying have been in long-term users, and in those folks that continue to use illicit opioids, injectable treatment with diacetylmorphine and hydromorphone – it is not only superior care it is cost-effective,” he said.

“It’s just time for this to expand, the evidence supporting that has been around for many, many years.”